Physical Therapy for Cervical Spinal Stenosis

Physical Therapy for Cervical Spinal Stenosis

Cervical spinal stenosis is a condition that most commonly affects individuals over the age of 50, and has the ability to lead to debilitating symptoms if it’s not treated properly. Physical therapy can effectively treat the symptoms of cervical spinal stenosis helping you to get back to your normal activities as quickly as possible without pain.

What is Cervical Spinal Stenosis?

Cervical spinal stenosis refers to spinal canal narrowing in the neck region. The spinal canal narrowing can result in compression of the spinal cord and associated nerve roots, leading to uncomfortable and even painful symptoms.

Symptoms of Cervical Spinal Stenosis

Some patients may have no symptoms of cervical spinal stenosis; however, in many cases, symptoms develop gradually and worsen over time. The symptoms of cervical spinal stenosis vary depending on the location of spinal canal narrowing. Symptoms may include the following:

  • Weakness, numbness, and/or tingling in the arm, leg, hand, or foot.
  • Neck and/or shoulder pain.
  • Decreased fine motor skills of the hands.
  • Difficulty with balance and/or walking.
  • L’hermitte sign (generalized electric shock type of feeling in the arms and torso, most noticeable when the neck is bent).
  • Bladder and/or bowel changes (i.e. urinary urgency, incontinence).
  • Loss of function and paraplegia (in severe cases).

Causes of Cervical Spinal Stenosis

Cervical spinal stenosis is either congenital, which means the affected individual has a genetic predisposition to the condition, or acquired, which means that the affected individual has developed the condition after birth.

There are a variety of conditions that can lead to cervical spinal stenosis, including:

  • Disc Herniation
  • Cancer
  • Infection
  • Osteophytes (bony growths that often accompany osteoarthritis).
  • Scarring and/or inflammation of the ligaments of the spine.
  • Spondylolisthesis
  • Systemic bone disease that leads to overgrowth of bone in the cervical spine region.
  • Injury (i.e. car accident, fracture, etc.)
  • Spinal surgery

Physical Therapy Options 

While physical therapy cannot change the narrowing of the spinal canal, it can help to control your pain and increase function. A physical therapy program may contain a variety of treatments, including:

  • Ice and heat therapy:

    • Ice packs can be applied to the neck in 10 to 15-minute intervals to help control inflammation, while moist heat packs can be applied to the neck for up to 20 minutes at a time to increase blood flow to the area and soothe tightened muscles.
  • Stretching exercises:

    • The goal of stretching is to restore flexibility in the neck, upper back, arms, and trunk. Two common stretches that are recommended include:
      • Chin Tucks

        • Begin in a seated position.
        • Position your chin parallel with the floor.
        • Retract your head backward.
        • Hold this position for 15 seconds.
        • Aim for 3 repetitions.
      • Scalene stretch

        • Begin in a seated position.
        • Tuck your chin toward your chest.
        • Bend your head slightly to the right.
        • Hold this position for 15 seconds.
        • Slowly return to the starting position.
        • Repeat by turning your head to the left.
        • Aim for 3 repetitions on each side.
      • Postural re-education:

        • The goal of this type of training is to restore normal spinal alignment to help reduce strain on the neck and upper back. Two commonly recommended exercises include:
          • Scapular retraction
            • Begin by standing with your arms at your sides with your head and neck in a neutral position.
            • Pull your shoulders back and squeeze your shoulder blades backward and downward.
            • Hold this position for 5 to 10 seconds.
            • Return to the starting position.
            • Aim for 3 repetitions.
          • Backward shoulder shrugs
            • Begin by sitting on the floor.
            • Slowly lift your shoulders up, and roll them back and down.
            • Slowly return to the starting position.
            • Aim for 2 sets of 10 repetitions.
  • Strengthening exercises:

    • The goal of strengthening is to improve strength in the supporting muscles of the neck and upper back, which helps to maintain proper posture.
  • Manual therapy:

    • Mobilization and manipulation of the joints in the neck and upper back can help to increase joint range of motion.
  • Cardiovascular exercises:

    • The goal of cardiovascular training is to increase blood circulation and increase stamina, which helps to promote overall physical conditioning.

Your physical therapist will also advise you on proper ergonomics, as well as proper lifting, bending, and pulling techniques to avoid excess strain on the neck and upper back.


Cervical spinal stenosis can lead to debilitating symptoms that can interfere with your ability to perform even the normal activities of daily living. Physical therapy, including stretching and strengthening exercises, as well as manual therapy and other treatment options, performed by a trained physical therapist at Blue Hills Sports & Spine Rehabilitation can help to control your symptoms and get you back to your normal activities without pain.